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General NPI Number Information
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NPI Number | 1780362467
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Entity Type | Individual
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Provider Name | MONICA DIONISIO CANLAS PT
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Gender | Female
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Dates
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Enumeration Date | 07/11/2023
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 1455 E PUTNAM AVE 2ND FLOOR,
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City | OLD GREENWICH
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State | CT
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Zip | 06870
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Country | US
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Telephone | 203-817-0196
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Fax |
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Provider Business Mailing Address
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Address Line | 1455 E PUTNAM AVE 2ND FLOOR,
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City | OLD GREENWICH
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State | CT
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Zip | 06870
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Country | US
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Telephone | 203-817-0196
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05060101
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 13874
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License Number State | CT
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